MARICOPA_COUNTY_DEPT_OF_HEALTH_DIGNITY AMENDMENT (002).PDF

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CONTRACT NO:  C-86-24-080-X-01 
 
 
 
 
AMENDMENT NO:         1        
 
 
AMENDMENT TO 
CONTRACT FOR SERVICES 
Between 
MARICOPA COUNTY  
by and through 
DEPARTMENT OF PUBLIC HEALTH 
and 
DIGNITY HEALTH 
 
 
I. 
The above-named contract is hereby amended as specified below: 
 
A. Section II, SCOPE OF WORK, page 14 – CHNA Report – Item 1. Vii: Combined Joint Venture 
Report: Item c; changed from “East Valley Rehabilitation Hospital” to “East Valley 
Rehabilitation Hospital – Chandler” 
 
B. Section II, SCOPE OF WORK, page 14 – CHNA Report – Item 1. Vii: Combined Joint Venture 
Report: removed “OASIS Hospital” from item d.  
 
C. Section II, SCOPE OF WORK, page 14 – CHNA Report – Item 1. Vii: Combined Joint Venture 
Report: added “East Valley Rehabilitation Hospital – Gilbert” as item d. 
  
II. 
All other terms and conditions of the original contract shall remain in full force and effect. 
 
 
IN WITNESS WHEREOF, the parties agree to the changes indicated herein: 
 
      
FOR AND ON BEHALF OF                            
MARICOPA COUNTY 
 
FOR AND ON BEHALF OF 
DIGNITY HEALTH                              
 
By: 
 
 
By: 
 
Chairman, Board of Supervisors 
 
 
 
 
Date 
 
 
Date 
ATTEST: 
 
 
Clerk of the Board 
 
 
 
 
Date 
 
 
APPROVED AS TO FORM:
 
 
 
 
 
Attorney for Maricopa County 
 
 
Date 
 
 
 
Docusign Envelope ID: 8E242AAF-2AB4-4B41-B247-691466BF79C6
Oct 31, 2024

Certificate Of Completion
Envelope Id: 8E242AAF2AB44B41B247691466BF79C6
Status: Completed
Subject: Maricopa County Dept of Health Amendment
Source Envelope: 
Document Pages: 1
Signatures: 1
Envelope Originator: 
Certificate Pages: 3
Initials: 0
Anne Moulton
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
185 Berry Street, Suite 300
San Francisco, CA  94107
Anne.Moulton@CommonSpirit.org
IP Address: 165.85.200.94  
Record Tracking
Status: Original
             10/30/2024 9:49:21 AM
Holder: Anne Moulton
             Anne.Moulton@CommonSpirit.org
Location: DocuSign
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Tim Bricker
Tim.Bricker@commonspirit.org
SVP
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(None)
Signature Adoption: Pre-selected Style
Using IP Address: 12.250.234.202
Sent: 10/30/2024 9:52:35 AM
Resent: 10/31/2024 12:49:29 PM
Viewed: 10/31/2024 1:46:35 PM 
Signed: 10/31/2024 1:46:43 PM
Electronic Record and Signature Disclosure: 
      Accepted: 10/30/2024 6:15:28 PM
      ID: ee3e6bfc-7d22-4611-b423-eb15e261922a
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Anne Moulton
anne.moulton@commonspirit.org
Contracts Manager
Security Level: Email, Account Authentication 
(None)
Sent: 10/31/2024 1:46:44 PM
Electronic Record and Signature Disclosure: 
      Accepted: 8/5/2024 9:15:02 AM
      ID: 1d2b5d98-98b5-4bcd-b8f7-11ac6d0f74e9
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10/31/2024 1:46:35 PM
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10/31/2024 1:46:43 PM
Completed
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10/31/2024 1:46:44 PM

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Electronic Record and Signature Disclosure

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Electronic Record and Signature Disclosure created on: 8/29/2022 9:29:07 AM
Parties agreed to: Tim Bricker, Anne Moulton